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W. D. !vm <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or cro.55ssed out <br />Everett, ........................ .......•_7�..................Fi�-�..—.—. <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />lations of the Water Department, for purposes and fixtures stated below. <br />During the time that any of the water mains may be taken up by reason <br />of any improvements authorized by the City of Everett, in or of any street or <br />alley in which they may have been laid, the City will not be required to furnish <br />water during the progress of such improvements to any consumer whose sup- <br />ply may thus be cut off, or be liable for any damages for its failure so to do. <br />Application Nq�.�.k,(..n_........... <br />Block........................................ Lot...........e?..0.................. Add ................................... _....... <br />N.................✓r....J� 01...-_.: ............................ <br />The work to be executed by ... ........... ........ _.............. .......... ...................... Plumbe <br />State size of tap. <br />... ...Tap to be inserted in the main. <br />......Water closet <br />i !! L <br />.�k.....Bath <br />................Urinal SEP 2 1 i0 <br />................ Plain faucet inside <br />walk washer City. of EZ rcIt'y4il <br />................Side <br />................Hose bib outside !YrATER PEP-T. E <br />................Hose bib for building purposes <br />................Hose bib inside <br />................Bib for stable containing ................ ..stall ...... ........ ...... <br />................Number of persons in family <br />....�a......Number of rooms in building <br />The premises are to be used as a .............. ............. ............... ... ............... <br />The owner of the premises is ........................................... ......................................... <br />The agent is ...................................... ....... .................................. <br />This application, although signed, shall not be binding upon the City, until <br />accepted by th• ipey(yt�endant the/Wa <br />of Department. <br />Signed ._l..... �..%..:......Q..:..)AC.-Y-,.�:+.:'.^.:...................Applicant <br />Accepted .......................... ...............1@By <br />Superintendent. <br />